The Diagnostic and Economic Yield of Neuroimaging in Neuro-ophthalmology

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Title Journal of Neuro-Ophthalmology, June 2012, Volume 32, Issue 2
Date 2012-06
Language eng
Format application/pdf
Type Text
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
ARK ark:/87278/s65m9bs4
Setname ehsl_novel_jno
ID 227313
Reference URL https://collections.lib.utah.edu/ark:/87278/s65m9bs4

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Title The Diagnostic and Economic Yield of Neuroimaging in Neuro-ophthalmology
Creator Mehta, Sonia; Loevner, Laurie A; Mikityansky, Igor; Langlotz, Curtis; Ying, Gui-Shuang; Tamhankar, Madhura A; Shindler, Kenneth S; Volpe, Nicholas J
Affiliation Departments of Ophthalmology (SM, MAT, KSS) Radiology (LAL, IM, CL), University of Pennsylvania School of Medicine; Center for Preventative Ophthalmology and Biostatistics (G-SY), University of Pennsylvania School of Medicine; Department of Ophthalmology (NJV), Northwestern University Feinberg School of Medicine.
Abstract Diagnostic studies such as computed tomography scans (CT) and magnetic resonance imaging (MRI) are ordered frequently in neuro-ophthalmic practice, although the diagnostic yield and cost-effectiveness of these tests have been studied for only a few conditions. We assessed the diagnostic and economic yield of CT and MRI across all patients evaluated in a neuro-ophthalmology practice. This retrospective review included all patients referred by the division of neuro-ophthalmology at the Scheie Eye Institute for CT, CT angiography, MRI, MRA, or magnetic resonance venography over a 12-month period. Abnormal imaging findings were categorized as significant (one that elicited changes in management) and/or relevant (one that related to the patient's neuro-ophthalmic complaint or examination findings). The diagnostic yield of the test ordered was analyzed according to the patient's chief complaint, neuro-ophthalmic examination findings, and indication for imaging. The total costs for each diagnostic group and costs per significant finding were calculated using the global Resource-Based Relative Value Units for each examination from the Centers for Medicare and Medicaid Services Web site. Two hundred eleven imaging studies in 157 patients were evaluated. 28.9% (95% confidence interval, 22.5%-36.2%) of imaging studies had significant abnormalities relevant to the neuro-ophthalmic complaint. Imaging obtained for evaluation of progressive optic nerve dysfunction and cranial nerve palsy had statistically significant higher diagnostic yield than studies performed for other reasons. Total cost of all imaging studies performed was $107,615.72. Cost per clinically significant and relevant finding was $1,764.19. In comparison to the diagnostic yield of neuroimaging studies in other specialties, CT and MRI of the brain requested by neuro-ophthalmologists provide significant and relevant data at a reasonable cost.
Subject Adolescent; Adult; Older people; Older people, 80 and over; Cost-Benefit Analysis; Eye Diseases; Female; Follow-Up Studies; Humans; Magnetic Resonance Imaging; Male; Middle Older people; Neuroimaging; Ophthalmology; Retrospective Studies; Tomography, X-Ray Computed; United States; Young Adult
OCR Text Show
Format application/pdf
Publication Type Journal Article
Collection Neuro-Ophthalmology Virtual Education Library: Journal of Neuro-Ophthalmology Archives: https://novel.utah.edu/jno/
Publisher Lippincott, Williams & Wilkins
Holding Institution Spencer S. Eccles Health Sciences Library, University of Utah
Rights Management © North American Neuro-Ophthalmology Society
Setname ehsl_novel_jno
ID 227302
Reference URL https://collections.lib.utah.edu/ark:/87278/s65m9bs4/227302
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